Table 3.

Case reports supportive for diagnosis of asthma, rhinitis, and anaphylaxis caused by persuphates in hairdressers (n = 8)

Author, year of publication, country	Age (years), females	Case history	Methods	Main outcome
Harth et al. (2006) Germany	26	Development of asthmatic symptoms after 8 working-years	SPT + to house dust mite, pollens, negative to APS; NSIC + ; SIC to APS + (only late reaction); patch test + to Ni, Co, PPD, APS, glycerol monothioglycolate	Occupational asthma case, relevance of contact sensitization for diagnosing airway disease was discussed
Figueiredo et al. (2008) Brazil	37	Development of nasal symptoms at work after 6 working-month, asthmatic symptoms after 3 working-years	SPT negative, including APS and PPS; total IgE normal; patch test + to colophonium, thimerosal, Ni; NSIC + ; SIC with PPS +	Occupational asthma due to PS can be diagnosed only by SIC
Bregnhoj and Søsted (2009) Denmark	29	Hairdresser with eczema and asthma developed 2 and 3 years after beginning to work, respectively	Patch test + to PPD, APS; SPT + to cat, horse, APS; neg.SPT to PPS	Eczema and asthma with type-1 and type-4 allergy caused by APS, without cross-reactivity to PPS in type-1 allergy
Pala et al. (2011) Italy	25	Onset of rhinitic symptoms and cough 2 years after beginning of work with bleach	SPT neg. to APS, NSIC negative, patch test + to Ni; total IgE normal; SIC + nasal response only, after SIC FeNO increase, eosinophil increase in nasal secretion and blood	Case of occupational rhinitis, suspected nonasthmatic eosinophylic bronchitis
Hoekstra et al. (2012) Nederlands	36	Rhinitis, asthma, and contact urticaria provoked by bleach at workplace	SPT + to APS and PPS; patch test + to APS and PPS after 20 min, specific IgE negative to APS	Case of systemic reaction to PS after skin contact; careful protocol should be employed- patch test read after 20 min, titration SPT; mechanism of immediate reaction unclear
Hougaard et al. (2012) Denmark	18 (apprentice)	Hand eczema and asthma developed 15 months after beginning education	SPT + to APS and PPS, positive PEF- monitoring, patch test + to APS	Occupational asthma and dermatitis caused by PS
Herin et al. (2012) France	38	Chest thightness, dyspnoea, noisy breathing, dysphonia, cough in association with bleaching procedures after 17 working-years	Total IgE normal, SPT negative to PS, NSIC negative, spirometry normal, SIC to PS negative, but symptoms like dysphonia, cough, sore throat occured; clinically vocal cord oedema was observed	Case of irritant vocal cord dysfunction after exposure to PS, occupational asthma excluded by SIC
Kleniewska et al. (2016) Poland	50	Rhinitis and contact urticaria at work after 15 working-years, attack of anaphylaxis (facial oedema, severe dyspnea) to PS in dental cement during dental procedure	Total IgE elevated, specific IgE + only to latex, negative to APS; NSIC negative; SPT + to APS, PPS, latex, grass; patch test + to APS; SIC to bleach product + after 15 min (sneezing and urticaria)	Case of allergic contact dermatitis, contact urticaria, and anaphylaxis to PS

PS persulphates, APS ammonium persulphate, PPS potassium persulphate, SPT skin prick test, SIC specific inhalation challenge, NSIC nonspecific inhalation challenge, FeNO fraction of exhaled nitric oxides, IgE immunoglobulin E, PEF peak expiratory flow, Ni nickel, Co cobalt, PPD p-phenylendiamine

*Maximum score = 15; scores ≥ 70% of maximum score are in bold